72% of hospital CFOs consider end-to-end revenue cycle management outsourcing to be the best solution until value-based payment models are better established.72% of hospital CFOs consider end-to-end revenue cycle management outsourcing to be the best solution until value-based payment models are better established.

Accelerate Your Financial Management Progress with Tools for Denial Management and Cost to Collect

by
on .

quotation marksThere’s a significant opportunity to invest in tools that are preventative in nature.quotation marks

Whether your organization is an employed physician group, hospital or health system, optimizing your revenue cycle provides an excellent opportunity for margin improvement. Denial management and cost to collect, in particular, are key areas where you can reduce costs, report experts David Dyke, vice president of Product Management & Business Development, McKesson Health Solutions, and Bess Ann Bredemeyer, RN, BSN, CHC, CHPC, CPC, senior director of Healthcare Consulting, McKesson Business Performance Services.

Dyke: Traditional denial management activities are focused on worklists, driven by volume, age or value. More progressive models attack denials systematically, both at their source and driven by their cost of resolution. There’s a significant opportunity to invest in tools that are preventative in nature, focused on areas like registration quality, patient coverage and eligibility, as well as clinical areas such as medical necessity and authorizations.

In terms of cost to collect, providers should focus on accelerating patient collections earlier as well as improving the patient collection rate. Both can be improved by setting appropriate expectations and making it easy for patients to pay.

Bredemeyer: For hospitals with employed physician groups, one of the greatest margin improvement opportunities is ensuring they have experts in the physician revenue cycle – from charge capture through timely filing – and timely follow-up on correct payment and denials management.

We frequently see large, competent hospitals fail to truly embrace the uniqueness of the physician revenue cycle. Sometimes the same words in the hospital world don’t have the same meaning in the physician world, and organizations need to dig deep to help ensure each step of the revenue cycle makes sense to their physician groups.

To discover more valuable insights and tips to successfully manage costs and operations, download our free eBook: Conquering Margin Improvement in a Changing Environment.

 

Authors

About Bess Anne Bredemeyer

Bess Anne Bredemeyer

Bess Ann Bredemeyer is senior director of Consulting, where she oversees the charge capture audit program to support facility financial compliance and the physician coding and billing compliance teams at McKesson. Her more than 25 years of healthcare experience includes serving as a compliance officer for an academic osteopathic medicine health science center, working with healthcare defense attorneys and state licensing boards, and providing overall coding, compliance and billing consulting services.